Small Things Often

This article first appeared in the September/October 2006 issue.

A Gottman Method therapist isn’t a healer, shuttle diplomat, or referee, but rather a trainer hunched next to a boxing ring with a towel over one shoulder. The therapeutic goal is to train both partners in the behavioral and communications skills used naturally by happy couples, rather than get in the middle and do the work for them. Pointers and behavioral training are supplemented by “cheat sheets,” checklists, and exercises for practice at home. Therapists coach couples to do “small things often” to build marital friendships, rather than trying to engineer dramatic breakthroughs.

Throughout the process, the therapist balances the niggling work of skills training with modeling acceptance of conflict and personality differences, described as inevitable in any marriage.

Therapy is divided into distinct modules, mixed and matched as needed, and not always applied sequentially.

• Assessment. Before therapy begins, each partner independently fills out up to 30 paper-and-pen questionnaires assessing disengagement, thoughts of divorce, abuse, styles of conflict resolution, etc. Separate and joint oral interviews follow. The therapist then sums up the relationship’s strengths and deficits, and presents a road map and a therapeutic contract. Research is cited to give the couple hope. Seemingly insurmountable tasks are broken into doable, bite-size pieces. Some couples, such as those with abuse issues or insufficient commitment, are screened out of therapy.
• Skills Training. From the start, the therapist authoritatively labels and prohibits any expression in sessions of the Four Horsemen—criticism, contempt, defensiveness, and stonewalling. As a wake-up call, a video of an in-session conflict may be played back to the couple and the Four Horsemen pointed out.

In this module, changes are gradual and exercises fun and simple. Each spouse can change behavior independently. Behavioral antidotes are taught. Contempt is softened by self-conscious daily practices of praise, curiosity, and engagement, such as asking about the partner’s day, making appreciation lists, and planning fun things together. Criticism is replaced by confining complaints to specific behaviors and raising issues gently. Defensiveness is lessened by contemplating one’s part in problems and by being willing to do at least some of what one’s partner asks.

• Flooding and Self-Soothing. As an antidote to stonewalling, therapists coach the couple in deep breathing, relaxation, and other self-soothing techniques to manage physiological flooding—particularly problematic for men and for women with traumatic backgrounds. Heart monitors are used in sessions to show when heart rates top 100, since some clients can look cool as cucumbers even when they’re in acute emotional and physiological distress.
• Learning to Fight. Once the marital friendship is renewed, couples are taught to regulate conflict. Conflict is normalized, and subdued, disengaged couples are encouraged to speak frankly, even if it means starting a fight. The overarching goal isn’t resolution of disputes but conflict management—a learned ability to fight with humor, authenticity, and tolerance, rather than with contempt, rigidity, and futile attempts to “win” once and for all.

The goal is to use fights to understand each other better, improve behavior, and get closer. Negotiation and compromise are taught for those few conflicts that are resolvable. Men are encouraged to share power. Failure is normalized and rituals of repair and reconciliation taught.

• Creating Shared Meaaning. Once the fundamentals of healthy fighting are under the couple’s belt, the stage is set for deeper discussions of meaning through the “dreams within conflict” intervention. Partners are taught to play reporter for 15 minutes each, muting their own reactions and asking open-ended questions like “Is there a story or some history that relates to your view? Is there a dream about the future or maybe a fear from the past?” The goal is to teach each partner to recognize and honor the other’s life dreams, which often underlie gridlocked conflicts.

When couples come in who are too alienated for behavioral coaching, the Gottmans often try to jump-start therapy with the “dreams within conflict” intervention. The object of the intervention is to create a temporary but dramatic feeling of improved understanding and emotional reconciliation, generating enough hope to return to skills training.

Throughout, couples are encouraged to transform self-conscious daily rituals of connection into family habits. This means having regular stress-reducing conversations, asking about a partner’s dreams, and finding ways to regularly connect during leave-takings, mealtimes, dates, getaways, extended family celebrations, and lovemaking. Because most couples therapies have a dismal history of relapse, time between sessions is slowly increased, and periodic booster sessions are scheduled.

Strengths

Drawing from narrative, existential, behavioral, feminist, and psychodynamic approaches, the Gottman Method gives therapists an encyclopedic library of assessment questionnaires, checklists, homework exercises, and interventions, with a blueprint for how to use them.

Therapists say this gives form to what previously had been intuitive and sometimes hair-raising work. Clinical social worker Michael Basta of Glen Ellen, California, for example, said that prior to the Gottman training, he’d find himself with a furious couple and “try to do some sort of conflict resolution, drawing on behavioral principles and what I knew from my own marriage.” Now he has the confidence and authority to interrupt the Four Horsemen and to tell husbands about the importance of honoring their wives’ dreams and accepting their influence. “Without John’s database, you speak from a value position, maybe a feminist value position,” he said. “It’s one person’s opinion against another. But if you lay this out in terms of statistics, the guys will stop and take notice.”

Other therapists say the easy exercises give couples hope. “The first couple I gave this to was so enthralled that they both came in with notebooks, their handouts all collected,” said Tim West, a marriage and family therapist in Novato, California.

“It showed me how much people were hungering for a structure and a routine that could contain and protect relationships. These were people who weren’t sophisticated in other ways–they were truck drivers, laborers, gardeners—they’d come in with their little pages in their hands. It’s very touching”

The exercises are particularly helpful for men. “Men are intimidated by that open- ended, amorphous, emotional domain that they think women have sway over and therapists are going to make them dive into no matter what,” West continued. “John has made this so friendly for men, with its structured lists. They realize, [bullet]I think my wife is really helpful, I can write that down.’ They’re starting to communicate with their wife in safety, rather than withdrawing. They’re reaching out and being proactive, and the women love it.”

Limitations

The systematic, skills-building approach works best with the least distressed couples. It provides a foundation for therapy focused on the importance of daily practices in marriage. But it doesn’t offer anything particularly groundbreaking in terms of intervention with couples who are in big trouble. There isn’t much emphasis on developing the therapist’s capacity as an instrument of soothing and safety.

“Friendship itself will not transform a marriage that needs emotional connection,” said Tim West, who’s also trained with Susan Johnson in Emotionally Focused Couple Therapy. “You need to go down into traumatic events—what Sue calls attachment wounds—that are often unconscious, resisted material, and shame- and fear-based. They’re afraid to share it with the person they love the most.

“In such cases, people need to be coached, coaxed into the emotional area. It’s such tender, careful, fragile work. Your love map exercises and your appreciation lists and your date nights aren’t going to bring that out.”